34.192.94.100
<?xml version="1.0" encoding="UTF-8"?>
<RegistrationXML>
  <ReferenceId>6198b1b4</ReferenceId>
  <PlanId>2</PlanId>
  <DeductibleAmount>0</DeductibleAmount>
  <MaximumLimit>60000</MaximumLimit>
  <StartDate>01/11/2018</StartDate>
  <EndDate>01/15/2018</EndDate>
  <DestinationPlan>Canada</DestinationPlan>
  <NoOfApplicants>1</NoOfApplicants>
  <PersonalInfo>
    <Applicants>
  <Applicant>
    <Firstname>BORUCH</Firstname>
    <Middlename/>
    <Lastname>GLEIBERMAN</Lastname>
    <Age>20</Age>
    <Dob>06/23/1997</Dob>
    <Gender>Male</Gender>
    <SportsRider>no</SportsRider>
  </Applicant>
</Applicants>
  </PersonalInfo>
  <DepartureInfo>
    <HomeCountryDepartureDate>01/11/2018</HomeCountryDepartureDate>
  </DepartureInfo>
  <ApplicantAddress>
    <ResidenceAddress>
      <Address1>509 NORTH LAKE DR</Address1>
      <Address2/>
      <Country>United States</Country>
      <State>New Jersey</State>
      <City>LAKEWOOD</City>
      <Postcode>08701</Postcode>
    </ResidenceAddress>
    <CitizenshipCountry/>
    <Email>noemail@squaremouth.com</Email>
    <Phone>
      <Home>7328869441</Home>
    </Phone>
  </ApplicantAddress>
  <Beneficiary>
    <AdDBeneficiaryName/>
    <AdDBeneficiaryRelationship/>
    <UniqueIdentifierType/>
    <UniqueIdentifierNumber/>
    <IssuingCountry/>
  </Beneficiary>
  <CourierCharges>No</CourierCharges>
  <PaymentMethod>
    <Creditcard>
      <CreditcardType>Visa</CreditcardType>
      <CreditcardNumber>4147202252488562</CreditcardNumber>
      <NameonCreditcard>BORUCH  GLEIBERMAN</NameonCreditcard>
      <CreditcardExpirationMonth>5</CreditcardExpirationMonth>
      <CreditcardExpirationYear>2019</CreditcardExpirationYear>
      <CreditcardAmount>7.75</CreditcardAmount>
      <CreditcardCodeNumber>195</CreditcardCodeNumber>
    </Creditcard>
  </PaymentMethod>
</RegistrationXML>

------------Response---------------
449a01fe
ARS-02-0038779
<?xml version="1.0" encoding="UTF-8"?><RegistrationRes><ReferenceId>6198b1b4</ReferenceId><LoginUrl>https://www.azimuthrisk.com/client_login.php</LoginUrl><PolicyDetails><PolicyNumber>ARS-02-0038779</PolicyNumber><UserName>449a01fe</UserName><Password>449a01fe</Password></PolicyDetails></RegistrationRes>